Periodontal diseases are bacterial infections caused by microorganisms in dental plaque, which are affected by host/microbial interactions as are infections elsewhere in the body. A number of different systemic conditions which cause a decrease in host response are associated with an increased severity of periodontal disease. A predominant feature of these conditions is a decrease in number and/or function of polymorphonuclear leucocytes. Sickle cell anemia is one such condition which is associated with decreased resistance to infections, neutrophil abnormalities and microangiopathies. Surprisingly, however, an association between sickle cell disease and periodontal disease has not been investigated. The specific aim of this proposal is to investigate the severity of periodontal disease in sickle cell patients attending the Sickle Cell Center of the Univ. of Ill. compared with sickle cell trait and normal subjects. Established indices of plaque accumulation, gingival inflammation, attachment loss and radiographic evidence of bone loss will be used to assess periodontal disease. Sickle cell anemia will be diagnosed by cellulose acetate electrophoresis and the Sickledex test. Results of the study should lead to greater awareness of the effect of sickle cell anemia on periodontal tissues and an improved overall care for the sickle cell patient. In the longer term we intend to study the possible effects of periodontal disease on the severity of sickle cell anemia. If chronically infected periodontal tissues are shown to provide sufficient bacterial challenge to affect the status of the sickle cell patient, this would be of great significance for the overall health of these patients. Potentially fascinating studies on the interaction of the microvasculature of the chronically inflamed gingivae and the sickle red cell may be stimulated by the successful completion of this study.